| NPI | 1679684591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: MO R4P01) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO R4P01) |
| 2086S0129X (Licence: MO R4P01) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-09-25 |